KMID : 0371420170920010042
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Annals of Surgical Treatment and Research 2017 Volume.92 No. 1 p.42 ~ p.46
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Usefulness of intraopertive ultrasonography during directional atherectomy using SilverHawk/TurboHawk system
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Park Yoong-Seok
Heo Seon-Hee Hyun Dong-Ho Do Young-Soo Park Hong-Suk Park Kwang-Bo Kim Young-Wook Park Yang-Jin Lee Chul-Hyung Kim Dong-Ik
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Abstract
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Purpose: Directional atherectomy (DA) was introduced for the management of infrainguinal arterial stenosis or occlusive lesions. The procedure success rate in the DEFINITIVE LE study was determined using radiologic imaging. The aim of our study was to determine the usefulness of intraoperative ultrasonography (USG) during DA for evaluating the early results of this procedure.
Methods: Patients who underwent DA from January to December 2014 were reviewed retrospectively. Twenty lesions from 14 patients with femoral artery stenosis (>70% stenosis) with short segment occlusive lesions (<2 cm in length) were treated. Among 20 lesions, 3 were treated with the TurboHawk system with a protective device due to lesion calcification. The percentage of stenosis during and after DA was determined with USG.
Results: Median follow-up was 5.1 months, and the procedural success rate (<30% stenosis at the end of the procedure) was 100% on angiography, but only 30% on intraoperative USG. On USG, median residual stenosis was 40% (range, 28%?42%) at the end of DA, 40% (range, 30%?55%) at 1 month, 55% (range, 35%?85%) at 6 months, and 64% (range, 60%?100%) at 1 year. There was one dissection, but no cases of perforation, pseudoaneurysm, or thrombosis. Primary patency, which was defined as a peak systolic velocity ratio ¡Â3.5 with no reintervention at 6 months, was found in 18 lesions (90%), and 11 of 14 patients (78.6%) were free of ischemic symptoms such as claudication at 6 months.
Conclusion: Our results demonstrated that DA with intraoperative USG is an effective treatment option for short segment occlusive lesions of the femoral artery.
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KEYWORD
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Silverhawk, Turbohawk, Atherectomy, Ultrasonography
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